1.      Pectoralis Major (PM) is the largest and most superficial muscle in the anterior chest wall. It is an extremely powerful adductor, internal rotator, and flexor of the humerus and acts as an important dynamic stabiliser of the shoulder.

2.      Injuries of the PM muscle has increased in young people due to growing popularity of weight-training regimens and contact sports-related trauma (rugby, American football and wrestling). The most often cited mechanism of injury is in weightlifters performing the bench-press maneuver. Moreover, the administration of anabolic substances weakens the muscle and tendon.

3.      There are also other non-sports and atypical scenarios when PM muscle may be weakened and harmed. In this group the most common mechanism of injury was forced abduction with extension and/or external rotation during a fall or while lifting (for example elderly people in hospitals or nursing home residence). Moreover, the administration of drugs (steroids, anticoagulants…) ease the PM tear and makes the clinical diagnosis more difficult.

4.      Patients with a ruptured PM present in the acute phase with pain, extensive swelling, and ecchymosis of the anterior chest wall, axillae and medial aspect of affected arm. At clinical examination, patients may have aweakness with arm adduction, palpable defect along the course of the PM and/or thinning of the axillary fold (more specific signs).

5.      Radiologist has a pivotal role in accurate assessment and early diagnosis to enable more favorable functional and cosmetic result.